FirstRanker Logo

FirstRanker.com - FirstRanker's Choice is a hub of Question Papers & Study Materials for B-Tech, B.E, M-Tech, MCA, M.Sc, MBBS, BDS, MBA, B.Sc, Degree, B.Sc Nursing, B-Pharmacy, D-Pharmacy, MD, Medical, Dental, Engineering students. All services of FirstRanker.com are FREE

📱

Get the MBBS Question Bank Android App

Access previous years' papers, solved question papers, notes, and more on the go!

Install From Play Store

Download MBBS Orthopaedics PPT 3 Prosthesis After Amputations Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Orthopaedics PPT 3 Prosthesis After Amputations Lecture Notes

This post was last modified on 07 April 2022


Prosthesis after Amputations

Learning objectives

--- Content provided by FirstRanker.com ---

? Post operative and preprosthetic care
? Overview of prosthesis available for amputees
? Basics of evaluation of patients
? Prosthetic prescription

--- Content provided by FirstRanker.com ---


Postoperative and Preprosthetic Care

Individuals with New Amputation
? Likely to experience acute surgical pain

--- Content provided by FirstRanker.com ---

? Grieving the loss of his or her limb- requires significant psychological

adjustment.

Early Goals

--- Content provided by FirstRanker.com ---


? Healing of suture line and overall health

status.

--- Content provided by FirstRanker.com ---

? Enhancing early single limb mobility and self

-care

? Control of edema and pain management

--- Content provided by FirstRanker.com ---

? Optimal shaping of the residual limb for

prosthetic wear

? Assessment of the potential for prosthesis

--- Content provided by FirstRanker.com ---

Assessing Residual Limb Length and Volume

? Important determinants of readiness for prosthetic use, as well as

socket design

--- Content provided by FirstRanker.com ---


? Stump length needs to be documented

? Limb volume and shape of a transtibial residual limb is assessed

--- Content provided by FirstRanker.com ---

by taking successive circumferential measures

REHABILITATION

? Prosthesis

--- Content provided by FirstRanker.com ---


? Conventional- Cheaper to produce but are heavy.

? Endolite - composite carbon fiber is used.

--- Content provided by FirstRanker.com ---

? Has to be custom made and tailored to be useful to the patient.
? A large number of patients do not use their prosthesis if it is

cumbersome or heavy

--- Content provided by FirstRanker.com ---


Immediate postoperative prosthesis

The socket

--- Content provided by FirstRanker.com ---

? Interface between the residual limb and

the prosthesis

? All the forces from the ground during gait

--- Content provided by FirstRanker.com ---


are transferred to the limb

? Forces from the limb needed to control

--- Content provided by FirstRanker.com ---

the motion of the prosthesis are

transferred to the prosthesis


--- Content provided by FirstRanker.com ---

Extra component that is mounted directly

under the socket to reduce amount of torque

and shock

--- Content provided by FirstRanker.com ---


socket and pylon are concealed to within a

cosmetic cover.

--- Content provided by FirstRanker.com ---


Potential of Use

Level K 0
? No potential to ambulate or transfer safely with assistance .

--- Content provided by FirstRanker.com ---

Level K1
? Potential to use a prosthesis for ambulation on level surfaces at fixed

cadence.

--- Content provided by FirstRanker.com ---

? Limited and unlimited household ambulator.

K1- Solid-ankle, cushion-heel (SACH) foot

? Most basic prosthetic foot available.

--- Content provided by FirstRanker.com ---

? Immovable ankle and soft heel give

it the ability to absorb the impact of

heel strike

--- Content provided by FirstRanker.com ---


? Provides minimal energy return.
? For limited functional ability and

potential to ambulate.

--- Content provided by FirstRanker.com ---



Level K 2

? Potential for ambulation with the ability to traverse low-level

--- Content provided by FirstRanker.com ---


environmental barriers such as curbs, stairs or uneven surfaces.

? Typical of the limited community ambulator
? lightweight, have a flexible keel, a multiaxial ankle, and provide some

--- Content provided by FirstRanker.com ---


energy return

Level K 3

--- Content provided by FirstRanker.com ---

? Potential for ambulation with variable cadence.
? Ability to traverse most environmental barriers
? Have vocational, therapeutic, or exercise activity beyond simple

locomotion

--- Content provided by FirstRanker.com ---


? Hydraulic ankle/Microprocessor


Level K 4

--- Content provided by FirstRanker.com ---


? Potential for prosthetic ambulation

that exceeds basic ambulation skills,

--- Content provided by FirstRanker.com ---

exhibiting high impact, stress, or

energy levels.

? Typical of the child, active adult, or

--- Content provided by FirstRanker.com ---


athlete.

Selection of Foot- Importance?

--- Content provided by FirstRanker.com ---

? Ground reaction forces are transmitted
? Can be damaging to the person's residual limb, knee, hip, or back.
? Proper prosthesis - expand their capabilities and motivation

dramatically and allows them to improve range of activities

--- Content provided by FirstRanker.com ---


? At least design for one level above
A J- 20 years old

? A soldier, was when he endured traumatic injuries after driving

--- Content provided by FirstRanker.com ---


his motor vehicle over a landmine

? Below knee amputee
? Determined to run again and plans to enrol at a local college

--- Content provided by FirstRanker.com ---


Which foot does he require?

? K1
? K2

--- Content provided by FirstRanker.com ---

? K3
? K4


Answer ? K3 for daily use and K4 for running

--- Content provided by FirstRanker.com ---


Jaipur foot BK Prosthesis

? The shank is fabricated from locally

--- Content provided by FirstRanker.com ---

manufactured, durable, high-quality, high-

density polyethylene pipes (HDPE).

? The socket design used is either total

--- Content provided by FirstRanker.com ---


contact, which is vacuum-formed using a

polypropylene sheet, or open-ended, using

--- Content provided by FirstRanker.com ---

HDPE.

? This custom-made shank / socket is fitted

with the Jaipur Foot.

--- Content provided by FirstRanker.com ---



? Dorsi-flexion,
? Inversion / Eversion
? Transverse rotation

--- Content provided by FirstRanker.com ---

? Enables amputees to walk,

run, trek, swim, squat, sit cross

legged,

--- Content provided by FirstRanker.com ---


? walk on uneven terrain, work in

wet muddy fields

--- Content provided by FirstRanker.com ---

AMPUTATIONS OF THE HIP AND PELVIS

?Through the femur from

5cm distal to the lesser

--- Content provided by FirstRanker.com ---


trochanter .

?Disarticulations of the hip.

--- Content provided by FirstRanker.com ---

?Hindquarter amputations.
AMPUTATIONS OF THE UPPER LIMB

? Hand

--- Content provided by FirstRanker.com ---

? Preserve as much function as is possible.

? Salvage procedure

? Preserve length

--- Content provided by FirstRanker.com ---


? Mobility and sensibility

? Functions of pinch and grasp are very important.

--- Content provided by FirstRanker.com ---

AMPUTATIONS OF THE UPPER LIMB

? Wrist Disarticulations- Separate the carpal bones from the radius
? Forearm amputations- substance of the radius and ulna
? Elbow disarticulations- Humerus is preserved

--- Content provided by FirstRanker.com ---

? Arm amputations- 30% of humeral length
? Disarticulation of shoulder- less than 30% of humerus
? forequarter amputation- Shoulder and scapula
AMPUTATIONS OF THE UPPER LIMB

--- Content provided by FirstRanker.com ---

? Wrist amputations-preserve supination and pronation may be

transcarpal or disarticulation through wrist.

? Transcarpal ? Flexion and extension of radiocarpal joints should be

--- Content provided by FirstRanker.com ---


preserved

? Can be fitted with thin prosthetic wrist units.
? Long lever arm increases the ease and power to use the prosthesis.

--- Content provided by FirstRanker.com ---


FOREARM AMPUTATIONS

? Preserve as much length as possible.
? A smal stump is preferable to a through elbow

--- Content provided by FirstRanker.com ---

? Can be fitted with a good prosthesis.
DISARTICULATION ELBOW

? Broad flair can be firmly grasped by the prosthesis

--- Content provided by FirstRanker.com ---

socket

? Humeral rotation can be transmitted to the

prosthesis.

--- Content provided by FirstRanker.com ---


? Preferable to a more proximal amputation

ARM AMPUTATIONS

--- Content provided by FirstRanker.com ---

? Trans condylar after prosthetic fitting function as elbow

disarticulations

? Proximal level amputations require and inside elbow lock

--- Content provided by FirstRanker.com ---


mechanism and an elbow turntable

? Preserving the proximal humerus is valuable-cosmetical y the

--- Content provided by FirstRanker.com ---

contour of the shoulder is preserved and the grip of the socket is

better .


--- Content provided by FirstRanker.com ---

SHOULDER AMPUTATIONS

? Surgical neck
? Disarticulation of the shoulder
? Forequarter amputation

--- Content provided by FirstRanker.com ---

? With prosthesis function is so severely impaired that the prosthesis

can only be used as a holding device when performing activities

with both hands.

--- Content provided by FirstRanker.com ---


Conventional (body-powered)

transhumeral prosthesis

--- Content provided by FirstRanker.com ---



Terminal Devices
PROSTHETIC PRESCRIPTION

--- Content provided by FirstRanker.com ---

? socket design
? skin-socket interface
? suspension strategy
? Additional modular components

--- Content provided by FirstRanker.com ---

SUMMARY

? Prosthetic rehabilitation of persons with amputations is both

challenging and rewarding.

--- Content provided by FirstRanker.com ---


? Success is often difficult to measure purely in clinical terms
? Maximizing individual functional potential
? Appropriate amount of technology to assure acceptable outcomes

--- Content provided by FirstRanker.com ---

are highly predictive of success.